Yes, Medicare covers a lung cancer screening, and the annual low-dose CT scan is genuinely $0. The part that trips people up is who actually counts as covered: you have to clear all five eligibility rules and complete a counseling visit before your first scan. Get one of those wrong, and the free scan turns into a bill.
In This Guide
- Key Takeaways
- What Medicare Covers for Lung Cancer Screening
- Does Medicare Cover Your Lung Cancer Screening? The Five Rules
- The Age Gap: Medicare Stops at 77, the Task Force Says 80
- When the Scan Finds Something to Follow Up On
- Frequently Asked Questions
- Learn More
What Medicare Covers for Lung Cancer Screening
Medicare Part B covers one lung cancer screening a year with a low-dose CT scan, usually shortened to LDCT. When your provider accepts assignment, you pay nothing for it: no Part B deductible, no coinsurance.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
But there's a step that has to come first, and it catches people off guard. Before your first scan, Medicare requires a counseling and shared decision-making visit with your provider. You talk through the benefits and the real downsides, follow-up testing, over-diagnosis, false alarms, and the radiation from the scan, and decide together whether screening makes sense for you. That visit is also $0 on assignment.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
You also need a written order from your provider, both for that first scan and for every yearly scan after it. So this isn't a walk-in test. The order, plus the counseling visit the first time around, are the gates you pass through before the free scan.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
Does Medicare Cover Your Lung Cancer Screening? The Five Rules
Here's where "covered" gets specific. To get the $0 screening, you have to meet all five of these, not just one or two:Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
- You're between 50 and 77.
- You have no signs or symptoms of lung cancer (the screening is meant for people who feel fine, which doctors call asymptomatic).
- You have a tobacco smoking history of at least 20 pack-years.
- You're a current smoker, or you quit within the last 15 years.
- You have an order from your provider.
What's a pack-year? It's a way of measuring how much you've smoked over time. One pack-year means smoking an average of one pack (20 cigarettes) a day for a year, so 20 pack-years is a pack a day for 20 years, two packs a day for 10 years, and so on.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
Miss any one of these and the $0 screening doesn't apply. A pack-a-day smoker who quit 16 years ago is just past the 15-year window; someone who's 78 is just past the age limit. Both may still worry about lung cancer, and both fall outside Medicare's screening rules.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
The Age Gap: Medicare Stops at 77, the Task Force Says 80
Medicare's rules create an age gap. The U.S. Preventive Services Task Force, the independent panel that grades preventive care, recommends annual lung cancer screening for adults aged 50 to 80. Medicare's coverage rule stops at 77.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
So there's a real gap. If you're 78, 79, or 80, you meet the national recommendation to be screened, but you've aged out of Medicare's coverage band.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings That doesn't mean you can't be screened. It means Medicare's LDCT screening benefit won't cover it at $0 the way it would have a year or two earlier. If you're in that window and you have a heavy smoking history, it's worth a direct talk with your doctor about whether to screen and how it would be paid for.
When the Scan Finds Something to Follow Up On
The $0 covers screening, and only screening. If your scan turns up a nodule or spot that needs a closer look, what comes next is no longer the free preventive test.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings A follow-up diagnostic CT, a PET scan, or a biopsy is diagnostic care, billed the normal Part B way: the deductible ($283 in 2026) if you haven't met it yet, then 20% of the Medicare-approved amount.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles
That's not a reason to skip the screening. Catching something early is the whole point of it. It's just worth knowing that the $0 stops at the scan itself, so a follow-up bill later on isn't a surprise.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
Frequently Asked Questions
Is Medicare's lung cancer screening really free?
On assignment, yes, with no deductible and no coinsurance. The thing to watch isn't a hidden fee, it's a denied claim: if your provider doesn't accept assignment, or the paperwork shows you missed one of the five rules or skipped the counseling visit, Medicare can decline to pay and the full cost lands on you. So "free" hinges on getting the eligibility and the order right up front.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
What's a pack-year, and how do I know if I have 20?
You don't have to nail the math yourself. Your provider tallies your pack-year count at the counseling visit and makes the official call for the order. If you want a rough gauge before you go in, 20 pack-years is about a pack a day for 20 years, so if your history is anywhere near that line, it's worth raising, even if you're unsure you clear it.
Why do I need a visit before my first scan?
Because Medicare makes it a condition of coverage, not optional paperwork: skip the shared decision-making visit and your first scan isn't covered. Practically, it's your chance to ask about false positives, follow-up testing, and radiation before you commit, and to confirm your provider is placing the written order the scan requires. If you're set on screening, treat it as the appointment that unlocks the $0, not a hurdle.
I'm 78 and a former heavy smoker. Can I still get screened?
You can talk to your doctor about it, but you're past Medicare's coverage age band, which runs to 77. The U.S. Preventive Services Task Force recommends screening through 80, so a reader in the 78-to-80 window meets the national recommendation while falling outside what Medicare's screening benefit covers at $0. Ask your doctor whether to screen and how it would be paid for.Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
What happens to the cost if the scan finds something?
The free screening covers the scan itself. If it turns up something that needs a closer look, the follow-up, a diagnostic scan or a biopsy, is billed as regular diagnostic care: the Part B deductible if you haven't met it, then 20% coinsurance. That part isn't $0.Centers for Medicare & Medicaid Services. (2026). 2026 Medicare Parts A & B Premiums and Deductibles. cms.gov. Retrieved Jun 22, 2026, from https://www.cms.gov/newsroom/fact-sheets/2026-medicare-parts-b-premiums-deductibles,Centers for Medicare & Medicaid Services. (n.d.). Lung cancer screenings - Medicare.gov. medicare.gov. Retrieved Jun 24, 2026, from https://www.medicare.gov/coverage/lung-cancer-screenings
Learn More
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